Provider Demographics
NPI:1780621789
Name:VOYAGER GROUP, INC
Entity type:Organization
Organization Name:VOYAGER GROUP, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:VELLINGA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:636-936-0400
Mailing Address - Street 1:4800 MEXICO RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1666
Mailing Address - Country:US
Mailing Address - Phone:636-936-0400
Mailing Address - Fax:636-936-2252
Practice Address - Street 1:4800 MEXICO RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1666
Practice Address - Country:US
Practice Address - Phone:636-936-0400
Practice Address - Fax:636-936-2252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR5P16207LP2900X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO050055140OtherMEDICARE RAILROAD
MO491711815Other1ST HEALTH
MO2000224OtherUHC
MO249776OtherHEALTHLINK
MO35554OtherGHP
MO197791OtherBCBS
MO35554OtherCMR
MO63868010001OtherCIGNA
MOF04439OtherMERCY
MO072246OtherFMH/ EXCLUSIVE CHOICE
MO246938112Medicaid
MO197791OtherBLUE CHOICE
MO5339096OtherAETNA
MO2000224OtherPHP
MO491711815Other1ST HEALTH
MO63868010001OtherCIGNA
MO35554OtherCMR
MO246938112Medicaid
MO6675670001Medicare NSC
MO197791OtherBCBS